Healthcare Provider Details

I. General information

NPI: 1265465215
Provider Name (Legal Business Name): J'AIMEE A LIPPERT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 S HAGADORN RD STE 500
EAST LANSING MI
48823-6804
US

IV. Provider business mailing address

804 SERVICE RD STE A109B
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-432-6144
  • Fax: 517-432-6150
Mailing address:
  • Phone: 517-432-6144
  • Fax: 517-432-6150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number5101014683
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101014683
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: